MEDICARE: DR. SHAWANDA WILLIAMS-ANDERSON PH. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	33380	TX
2	103TC0700X	Clinical Psychologist	33380	TX
3	103TC2200X	Clinical Child & Adolescent Psychologist	33380	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831257492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAWANDA WILLIAMS-ANDERSON PH. D.

Provider Business Mailing Address
First Line	:	8300 CYPRESS CREEK PKWY
Second Line	:	SUITE 450
City	:	HOUSTON
State	:	TX
Zip	:	77070-5654
Country	:	US
Telephone Number	:	281-890-7776
Fax Number	:	281-890-7785

Provider Business Practice Location Address
First Line	:	8300 CYPRESS CREEK PKWY
Second Line	:	SUITE 450
City	:	HOUSTON
State	:	TX
Zip	:	77070-5654
Country	:	US
Telephone Number	:	281-890-7776
Fax Number	:	281-890-7785

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	08/24/2016

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